ABSTRACT Orthopaedic surgeons are the 3rd largest physician opioid prescribing group. Scholarly publications in the musculoskeletal disease and injury field have been inundated with manuscripts outlining local and subspecialty focused attempts to decrease the use of these medications and to identify patients at risk of chronic abuse. The interventions are generally are proscriptive, relative only to the site where it was developed, lacking in appropriate experimental design and un-scalable. Similarly, submitted analyses of large data sets examining opioid use are not optimally designed to identify characteristics of patients at risk for chronic opioid abuse. We plan to assemble a group of active investigators in the area of opioid management, including representatives from the editorial staffs of the major scientific publications in musculoskeletal medicine and surgery, to identify optimum research designs to address the issues of optimizing opioid prescribing patterns for low and high-risk patients and develop analytic approaches to apply to large administrative data sets to identify individuals at risk for chronic abuse. The goals of this one-day meeting are in line with NIAMS directed RFA?s Mechanisms, Models, Measurement and Management in Pain Research (PA 18-159, 18-141) as well as the NIH HEAL initiative both of which involve other NIH agencies. At the end of the meeting, the deliverables will be (i) optimum research designs which approach the issue across subspecialties and musculoskeletal conditions and which can be scalable across large health care systems, and (ii) analytic approaches for large data sets which identify at-risk patients. The meeting symposia will be published in a Journal of Bone and Joint Surgery supplement and shared with NIAMS.